Insomnia and Sleep Disorders

It’s common for many of those coping with hepatitis C to suffer from fatigue, lethargy, and sleep deprivation. Insomnia, a documented condition associated with hep C, affects 50% of patients with chronic hep C and mild liver disease who complained of daytime sleepiness, chronic fatigue, and poor sleep quality.¹ This percentage was a bit higher in the 2020 Hepatitis C In America Survey, where 61% of the respondents listed insomnia as a top symptom. (In this survey, the respondents were not solely those in the chronic stage and minor liver damage.)

Trouble sleeping for people with hep C

Sleep disturbance resulting in a reversal of the night and day cycles is a common attribute of hepatic encephalopathy, chronic liver disease, and cirrhosis.¹ However, in a small study of hep C positive women without overt cirrhosis, they also had higher scores for fatigue and sleep disturbances and lower quality of life scores than those without the disease.²

A good night sleep, like exercise and healthy eating, is critical to everyone’s health, but for those coping with hep C, it's especially important. Sleep deprivation can negatively impact the immune system and long-term sleep deprivation is a potential cause for the increase the severity of chronic HCV. Insomnia may also contribute to severe chronic fatigue, another top symptom as reported in the 2020 Hepatitis C In America Survey.

What causes insomnia?

The exact cause of insomnia for those who have hep C is not well understood. It may be related to the stress and/or anxiety frequently reported by hep C patients. It also is thought to be triggered by cirrhosis and by some of the earlier treatments, such as interferon. Interferon is rarely used in the US anymore, being replaced by direct-acting antiviral drugs, but it is still a treatment used in a few other countries.

Tips for better sleep

There are strategies that can be employed to reduce insomnia. One is non-habit-forming, over-the-counter sleep aids. However, these agents have chemicals that could task a damaged liver, and some recommendations suggest reducing stress on this organ by reducing the amount of chemicals it must process. Your doctor can help determine if sleep aids are right for you. Non-chemical strategies include hot baths, eliminating caffeine, lowering the bedroom temperature, and winding down before going to bed.

Diet can also affect sleep. The following are recommended for their ability to possibly improve sleep, including:³

• Whole Grains – High fiber grains (like brown rice, oats and quinoa) decrease appetite and associated hunger pangs that disturb sleep. They also release tryptophan (an amino acid that increases the calming neurotransmitter serotonin) and boosts melatonin (a sleep-inducing brain hormone).
• Pecans – Pecans are rich in B vitamins, particularly Vitamin B6, both of which are associated with insomnia reduction. Vitamin B6 is reputed to calm overactive nervous systems. Pecans contain pyridoxine that produces serotonin that stimulates the production of melatonin.
• Cherries – Cherries are one of the few food sources that actually contain melatonin and consuming them one hour before bed can help induce sleep.
• Bananas – Researchers at the University of Wisconsin have found that potassium may be one of the elements responsible for deep, slow-wave sleep, though a link has yet to be firmly established. Bananas contain tryptophan that can also be beneficial for sleep.
• Warm Milk – Milk contains tryptophan and calcium that have natural calming effects on the muscles and the central nervous system. Warming up milk minimizes the energy needed to digest it and can have a calming, relaxing effect that encourages sleep.